ICU应用微量泵中心静脉高浓度补钾有效性及安全性评价

目的探讨ICU-应用微量泵中心静脉高浓度补钾的有效性及安全性。方法回顾性分析ICU发生低钾血症78例患者的临床资料。随机分为常规组和高浓度组，每组各39例，补钾均在心电监护下进行。常规组钾浓度为40mmol／L，补钾速度为10～20mmol／h；高浓度组钾浓度为100～300mmol／L，补钾速度为加～200mmol／h，同时计算达到目标血钾浓度所需补钾量，监测两组血钾浓度、每小时尿量、达到目标血钾浓度所需时间及患者局部不良反应。结果两组患者治疗前均存在低钾血症，设定目标血钾浓度为4．0mmol／L，两组治疗前血钾浓度、所需补钾量比较差异无统计学意义，分别为（2．9±0．2）、（3．0±0．2）mmol／L和（85．2±8．7）、（92．3±7．6）mmol。常规组与高浓度组相比达到目标血钾浓度所需时间较长（17.25±4．49）h比（5．67±0．75）h，P〈0．01]。结论在ICU严密监护下应用微量泵中心静脉高浓度补钾安全、有效．有一定的临床廊用价值。

Evaluation of efficacy and safety of central venous infusions of concentrated potassium chloride corrects hypokalemia by micro-pump in intensive care unit

Objective To explore the safety and clinical efficacy of central venous infusions of concentrated potassium chloride corrects hypokalemia by micro-pump in intensive care unit（ICU）. Methods The data was analyzed retrospectively on 78 patients with hypokalemia in ICU. They were randomly divided into 2 groups： general group （39 cases） with potassium concentration 40 mmol/L and the rate 10-20 mmol/h, concentrated potassium group（39 cases ） with potassium concentration 100-300 mmol/L and the rate 40-200 mmol/h, calcuLating the whole potassium dosage respectively, examining the initial potassium concentration, urine volume per hour, the mean time to aimed potassium concentration and side effect. Results The initial potassium concentration and the whole potassium dosage were no significant difference between the two groups （2.9 ± 0.2 ）, （ 3.0 ± 0.2 ） mmol/L and （ 85.2 ± 8.7 ）, （92.3 ± 7.6） mmol, respectively ] （P 〉 0.05）. It took longer time reaching the aimed potassium concentration in general group than that in concentrated potassium group （17.25 ± 4.49） hours and （5.67±0.75 ） hours, respectively ] （P 〈 0.01 ）. There were no complications such as hyperkalemia, fatal arrbythmia and phlebitis. Five patients were bloating in general group. Conclusions Under meticulous monitoring, it is effective and reLative safely to correct hypokalemia by central venous infusions of concentrated potassium chloride using micro- pump in ICU. The therapy is of clinical value in treating hypokalemia patients.